‘They deserve very much better,” the distinguished paediatrician Hilary Cass concludes in the final report of her independent review of NHS gender identity services for children and young people. The report details how a vulnerable group has been “exceptionalised” by the NHS and denied the evidence-based healthcare all patients have the right to expect.
Just how badly wrong things went at the gender identity development service (Gids) is evidenced in the fact that Cass felt she had to explicitly state that, while some people argue that clinical care for children should be based on a “social justice” model, “the NHS works in an evidence-based way”. That should never have been up for debate: as the British Medical Journal argued in its editorial on the Cass review last week, it is deeply unethical to provide untested medical interventions for children that lack evidence of benefit, yet are life-altering and come with potentially very significant harms.
